When performing a draw on a diabetic patient with small, fragile veins, and the phlebotomist misses the patient's vein twice, what should the phlebotomist do next?
Ask another phlebotomist to obtain the specimen.
Perform the draw on a foot.
Repeat the draws until the phlebotomist is successful.
Perform the draw on a leg.
The Correct Answer is A
Choice A reason:
Asking another phlebotomist to obtain the specimen is a prudent step after multiple unsuccessful attempts. It can reduce the patient's discomfort and anxiety. A fresh perspective from another professional might increase the chances of a successful draw, especially in challenging situations like small, fragile veins often found in diabetic patients.
Choice B reason:
Performing the draw on a foot is not typically recommended due to the increased risk of infection and complications, especially in diabetic patients who may have reduced sensation and slower healing in their extremities. This option should only be considered when other more proximal sites have been deemed unsuitable.
Choice C reason:
Repeating the draws until successful is not advisable as it can cause undue stress to the patient and increase the risk of hematoma or vein damage. It is essential to minimize the number of attempts to prevent patient discomfort and potential complications.
Choice D reason:
Performing the draw on a leg is another option that is generally avoided unless absolutely necessary, due to similar reasons as drawing from a foot—risk of infection and complications. Additionally, it can be an uncomfortable position for the patient.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A reason:
The lateral section of the plantar heel is the recommended site for capillary blood collection in infants, particularly those under 6 months of age. This area is preferred because it is sufficiently vascularized for blood collection and poses less risk of injury to bones and nerves compared to other areas.
Choice B reason:
The central area of the heel is not recommended for capillary blood collection in infants due to the higher risk of injury to the calcaneus (heel bone) and potential for calcaneal osteomyelitis, an infection of the bone.
Choice C reason:
The posterior curvature of the heel is also not an appropriate site for capillary blood collection in infants. This area has a higher likelihood of causing pain and injury, as well as being less accessible for a proper puncture technique.
Choice D reason:
The palmer surface of the distal phalanx (fingertip) is not a recommended site for capillary blood collection in infants under 1 year of age. The fingertips of infants are small and more prone to injury, and the procedure may be more painful compared to a heel stick.
Correct Answer is B
Explanation
Choice A reason:
Performing a heel stick on a 5-year-old patient is not an appropriate technique. Heel sticks are typically used for infants, particularly newborns, to minimize discomfort and because their finger pads may not be fully developed for finger sticks. By the age of 5, a child's veins are usually developed enough for venipuncture, which is the preferred method.
Choice B reason:
Performing a finger stick on a toddler patient is an appropriate technique for specimen collection. This method is commonly used for children who are not yet old enough for venipuncture but have outgrown the heel stick method. The finger stick is performed on the palmar surface of the distal phalanx, usually of the middle or ring finger, and is considered safe and effective for collecting small blood samples in toddlers.
Choice C reason:
Performing a thumb stick on an infant is not an appropriate technique. The thumb has a pulse and is more sensitive, which can cause unnecessary pain and distress to the infant. Additionally, the thumb's size and increased movement make it a less suitable site for specimen collection in infants.
Choice D reason:
Performing a thumb stick on a 5-year-old patient is also not an appropriate technique. As with infants, the thumb's sensitivity and the presence of a pulse make it a less desirable site for blood collection. For a 5-year-old, venipuncture or a finger stick on a non-thumb finger would be more appropriate and less distressing.
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